Chapter 35 Geriatric Emergencies EMT
an aortic aneurysm.
A 73-year-old female experienced a syncopal episode while watching TV. She is now conscious, but is diaphoretic, tachycardic, and hypotensive. Your assessment reveals abdominal tenderness and a pulsating mass to the left of her umbilicus. You should suspect:
. the patient is experiencing delirious behavior, which suggests a new health problem. Correct
A 77-year-old female presents with an acute onset of altered mental status. Her son is present and advises that she has a history of hypertension, atrial fibrillation, type 2 diabetes, and glaucoma. He further advises that she takes numerous medications and that she is normally alert. When you assess this patient, it is important to note that:
pneumonia
A productive cough, fever, and chills in an 80-year-old patient with a compromised immune system should make you MOST suspicious for:
advance directive
A specific legal document that directs relatives and caregivers regarding the medical treatment that may be given to patients who cannot speak for themselves is called a(n):
a systemic infection
An 84-year-old male fell a week ago and has been bedridden since then. Today, he presents with an altered mental status. His skin is pale and cold and his respirations are rapid and shallow. The EMT should suspect:
is often the result of hypertension and atherosclerosis.
An abdominal aortic aneurysm:
chronically increased afterload.
As a person ages, the heart may enlarge as a result o
attempt to differentiate between chronic and acute problems.
Because of the complexity of the older patient and the vagueness of his or her complaint, you should:
renal insufficiency
Blood levels of medications may rise in the elderly, sometimes to toxic levels. This is MOST likely due to:
cataracts
Clouding of the lenses of the eyes is called:
an acute onset of dementia
Common causes of depression in the elderly include all of the following, EXCEPT:
a decreased ability to cough
During the natural process of aging, the number of functional cilia in the respiratory system decreases, resulting in:
frequently asking the patient if he or she understands.
Good general communication techniques with the elderly include
the patient develops cardiac arrest.
In contrast to a living will, a "do not resuscitate" (DNR) order becomes valid when:
is usually considered irreversible.
In contrast to delirium, dementia:
the body is less able to adapt the BP to rapid postural changes.
In contrast to younger patients, older patients are more prone to a decrease in blood pressure (BP) upon standing because:
a decrease in bone mass and density.
Osteoporosis is defined as:
physical
Poor maintenance of home, poor personal care, and dietary neglect are all possible indicators of ____________ elder abuse.
pneumonia
Sedentary behavior while healing from a hip fracture would MOST likely predispose the older patient to
caused by an interruption of blood flow to the brain.
Syncope in the older patient is
may cause the patient to think that he or she has no say in making decisions
Talking about an elderly patient in front of him or her to other members of the family:
tachypnea and paroxysmal nocturnal dyspnea
The EMT should suspect left-sided heart failure in the geriatric patient who presents with:
have only one EMT speak to the patient at a time
To minimize distractions and confusion when assessing an older patient, you should
heart disease
The leading cause of death in the geriatric patient is:
help EMS personnel remember what is different about elderly patients.
The purpose of the GEMS diamond is to
kyphosis
The stooped posture of some older people, which gives them a humpback appearance, is called:
polypharmancy
The use of multiple prescription drugs by a single patient, causing the potential for negative effects such as overdosing or drug interaction, is called:
direct your partner to manually stabilize her head while you quickly visualize her chest for signs of breathing.
Upon arriving at the residence of an elderly female who apparently fainted, you find the patient lying supine on her living room floor. She is not moving and her eyes are closed. A neighbor tells you that she found the patient this way but did not move her. When you gently tap the patient, she does not respond. You should:
accuse a caregiver of physical abuse.
When assessing an older patient who has multiple bruises in various stages of healing, the EMT should do all of the following, EXCEPT:
the injury may have been preceded by a medical condition.
When caring for a geriatric patient with a traumatic injury, it is important to consider that:
place blankets behind the patient's head
When immobilizing a patient with a kyphotic spine to a long backboard, the EMT would MOST likely have to:
recall that it will take a less severe mechanism of injury to cause significant injuries.
When performing your secondary assessment on an older patient who has been injured, it is important to:
Human resource agencies fail to investigate.
Which of the following is NOT a reason why the exact extent and prevalence of elder abuse is unknown?
the patient's residence is cold due to a malfunctioning heater
Which of the following observations or statements represents the "E" in the GEMS diamond?
A)Older patients tend to use more lethal means than younger patients.
Which of the following statements regarding suicide in the older patient is correct? A)Older patients tend to use more lethal means than younger patients. B)Older females have a higher rate of suicide than any other group. C)Depression and hopeless feelings are often not predisposing factors. D) Most suicidal patients readily seek care and do not deny the problem.
A)The process of aging is gradual, and the rate at which a person loses functions does not increase with age.
Which of the following statements regarding the aging process is correct? A)The process of aging is gradual, and the rate at which a person loses functions does not increase with age. B)Because he or she is younger and healthier, a 35-year-old person ages slower than a 75-year-old person. C)Human growth and development peaks in the late 40s or early 50s, at which point the aging process sets in. D) The older a person gets, the slower the decline in the function of vital organs, such as the kidneys and liver.
hyperosmolar hyperglycemic nonketotic syndrome
You are assessing a 70-year-old female who complains of intense thirst, frequent urination, and dizziness. She has a history of type 2 diabetes, heart disease, rheumatoid arthritis, and gout. Her blood glucose reads "high." She is conscious, but confused. Her blood pressure is 92/52 mm Hg, her pulse rate is 130 beats/min and weak, and her respirations are 22 breaths/min and shallow. This patient's clinical presentation is MOST consistent with:
she became dizzy or fainted before falling.
You are dispatched to a residence for an 80-year-old female who fell. When you arrive, you find the patient conscious, lying in a recumbent position on the floor in her living room. In addition to providing the appropriate treatment, you should ask the patient if:
determine the patient's baseline mental status.
You are dispatched to a skilled nursing care facility for an 80-year-old female with abnormal behavior. The patient is clearly confused and asks you if you are her husband. You should:
a subdural hematoma.
You receive a call for a sick person. When you arrive, you find the patient, a 75-year-old male, lying unresponsive in his bed. His respirations are slow and irregular and his pulse is slow and weak. His daughter tells you that he fell the day before, but refused to allow her to call 9-1-1. His past medical history is significant for hypothyroidism, deep vein thrombosis, heavy alcohol use, and liver cirrhosis. His medications include blood thinners and vitamins. You should be MOST suspicious that this patient is experiencing:
dementia and delirium
are both abnormal processes and must be carefully evaluated in geriatric patients
classic symptom of chest pain
many patients do not present with __ when experiencing a heart attack.
